Healthcare Provider Details

I. General information

NPI: 1649101312
Provider Name (Legal Business Name): KATHERINE MALDONADO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 COLONIAL VILLAGE LN STE 103
LANCASTER PA
17601-6709
US

IV. Provider business mailing address

164 TOM AVE
EPHRATA PA
17522-2483
US

V. Phone/Fax

Practice location:
  • Phone: 717-391-0172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW143852
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: